Deadline for Health: The Media’s Response to Covering HIV/AIDS, TB and Malaria in Africa
Research on Media in Botswana, Cameroon, Kenya, Malawi and Senegal

This research report was initiated by the International Women’s Media Foundation (IWMF) in Washington, DC; carried out with the African Women’s Media Center (AWMC, a project of the IWMF) in Dakar, Senegal; and funded by the Bill & Melinda Gates Foundation. It represents the first time that media coverage of HIV/AIDS, TB and malaria has been systematically evaluated across five countries in sub-Saharan Africa. Using similar methods of content analysis and a standard template for interviews, researchers were able to do comparable studies, integrate the results and make recommendations.

“The aim of this study was to assess the media coverage of these diseases and to identify the problems of addressing public health issues in the media,” said Lynn Povich, co-chair of the IWMF board of directors. “Now that we can benchmark the issues across several countries, we will be developing best practices and strategic interventions – in cooperation with media partners – for improving health coverage in Africa.”

From May to November 2003, in Botswana, Cameroon, Kenya, Malawi and Senegal, researchers analyzed at least two major newspapers in each country. Except in Kenya, where both newspapers were privately owned, the newspapers analyzed were both privately and state owned. In addition, researchers held focus groups with media workers, health professionals, staff from nongovernmental organizations, policymakers and the public; they also conducted separate in-depth interviews with middle- and top-level managers from these groups. Media workers were interviewed to gauge their understanding of health matters and the challenges they face in their work environments. The views of health professionals, non governmental organizations and the public were essential to illustrate how the media was perceived and how they, as consumers, assess the media’s performance.

Among the findings:

• The content analysis of the print media shows that while articles about HIV/AIDS overwhelmingly dominate health coverage in all five countries, the frequency of public health coverage in general was alarmingly inadequate. In Senegal, health stories accounted for only 2 percent – 4 percent of all the articles studied in two newspapers; in the three newspapers studied in Malawi, fewer than 3 percent of the stories analyzed were health-related, while in Cameroon, between 4 percent and 8 percent of the articles analyzed in the two daily papers were devoted to health issues. In Kenya, articles on HIV/AIDS accounted for 10 percent of all the articles studied in the daily newspaper and less than 2 percent of total coverage in the weekly. And in Botswana, where 37.3 percent of the country is estimated to have HIV/AIDS, health-related stories ranged from 10 percent of all coverage in the daily paper to less than 1 percent in the weekly.
• While coverage of HIV/AIDS is inadequate to the problem, the focus on that disease has been to the detriment of coverage on a whole range of other public health concerns, such as malaria, TB, diabetes, reproductive health, yellow fever, hepatitis, immunization and maternal and child health.
• Most health coverage is spot news or events (worldwide TB day), with a focus on personalities – especially government officials – rather than issues, analysis and educative (service) information. There is also little effort to analyze health issues within the larger context of developmental problems such as poverty and sanitation.
• According to UNAIDS, 58 percent of those infected with HIV in Africa are women – and women often experience greater stigma and discrimination than men. Still, there is a critical lack of health information targeted to women, who are also the primary caregivers and health deliverers; there is also little reporting on gender inequalities and discrimination and violence against women and girls as it relates to their health and well-being.
• There is scant coverage of the problems of the stigma of HIV/AIDS and of those dependent on the public health system – which includes the majority of citizens but especially affects the poor, the marginalized and the rural population.
• There is an urgent need to develop editorial material that engages young people and provides relevant health information, especially regarding sexually transmitted infections such as HIV.
• In the privately owned media, there is pressure to attract advertisers and sponsors and therefore a prejudice against stories perceived to be about “grim news.” And in the state-owned media, stories critical of government health spending, policies and delivery are more the exception.
• Journalists lack training in health and science reporting, have limited time and resources to pursue stories, and work in politicized environments in which they are expected to cover government pronouncements rather than scrutinize policy and health delivery systems.
• There are almost no coherent newsroom policies about sustaining coverage of specific health issues and very few reporters or desks, regular columns or dedicated programming devoted to the subject of health.
• There is a critical communication and coordination gap between the media and legislators, nongovernmental organizations, public health professionals and organizations.

“The media have incredible power to help Africa come to grips with the challenges of HIV/AIDS, TB and malaria,” said Akwe Amosu, executive editor of allAfrica.com who is currently working with the Economic Commission for Africa and who sits on the IWMF board. “But despite work by some trailblazing reporters and editors, these findings demonstrate a lack of capacity and a lack of courage in the media. The authorities and responsible people in Africa have to wake up to the crisis – and the media is an absolutely critical component. That’s why this project is so important and why we’re going to do everything we can to support the media.”

From the research and interviews undertaken last year, this report has compiled a set of recommendations addressed mainly to journalists, but also to health professionals, policymakers and nongovernmental organizations to help enhance the quality and consistency of coverage devoted to HIV/AIDS, TB and malaria. The next phase of this project will be to implement as many of these ideas as possible in three African countries – Botswana, Kenya and Senegal – working closely with major media houses in each country. After that, the IWMF and the AWMC, along with the media houses, will issue a summary of the project including a list of successful practices to present to other news organizations around the continent.

“From the study, it is evident what some of the challenges are in the media coverage of health issues in Africa,” said Emily Nwankwo, a Nairobi-based media consultant who sits on the IWMF board of directors. “In the next phase of the project, we will be working with selected media houses, in both print and electronic mediums, to suggest innovative approaches to public health reporting that will take better advantage of the resources of the media, the government and nongovernmental organizations so that the value, use and dissemination of health information can become more strategic and more effective.”